Breast Augmentation: Q&A
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Subglandular for my Breast Anatomy? (photo)
Hi, I am scheduled March 8th for a BA with over the muscle saline implants, possibly 450 cc's. I currently wear a 38B, 36C and have a 34 inch ribcage. I DO NOT want a breast lift. The PS I have chosen suggests over the muscle, and says due to my breast anatomy under the muscle may make the implants/breasts look distorted. I am looking for some advise (not the response with "go with what you PS says, lol"). With pics and info I have provided, what would you recommend? I don't want ball in a sack.
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21 Doctor Answers |
Asked by
NewMePls
in Windy City
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Breast Implant above or below the muscle?
HI,
Because you have a fair amount of droop to your breasts your options are limited. Based on the pictures you either need a lift with a submuscular implant or a sub-glandular implant to expand the breast envelope to its maximum (this will not completely correct the droop though).I would not recommend a 450 cc saline implant above the muscle however, as it will show obvious rippling. I recomend a smaller (400 cc silicone implant) in the subglandular plane with the knowledge that you may...
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Subglandular for my Breast Anatomy?
Some surgeons recommend subglandular implants for patients with ptosis as they feel that they will better fill out a loose skin envelope and help them avoid a lift. Unfortunately this rarely works, and even if it does for a time the patient's tissues stretch more under the weight of the implant than they would if the implant was subpectoral and a worse problem develops with irreversible thinning of the tissues and more sagging. A dual plane approach would offer better coverage, better...
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Subglandular for my Breast Anatomy
If you will not accept a breast lift, I would advise against breast implants. It is highly likely that your own breast tissue will wind up hanging off the implants, a very unsatisfying appearance. Then your choices will be three:
live with an unsatisfying outcomej
have a breast lift
have the implants removed, and perhaps be worse off than when you started and only a lift would solve that.
In terms of implant position, saline implants that large with the amount...
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Implants above or below the muscle
Unlike many of my colleagues, I think you will do fine with saline implants over the muscle BUT you need to understand that this will make your breasts larger and not change the position of your nipples. They will still be saggy. But this is quite normal for women with large breasts. Saline implants do tend to show wrinkles more than gel, but you have enough of your own tissue so that I don't think that will be a major problem for you. So as long as you understand that you will still be...
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"Ball in a Sack", "Rock in a Sock"
Dear New Me,
You cannot say "I don't want a lift and I don't want a ball in a sack" in the same sentence. For you, they are almost mutually exclusive. The only characteristic that may save you, is the wide base of your breasts. But I don't know if I'd bank on that. Good luck!
see video
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Sagging needs to be addressed before any Breast Augmentation
You have saggy breasts. You will need lift to look good after breast enlargement. Augmentation without lift will make your breasts even saggier. Submuscular implants without lift will give you instantaneous double bubble deformity.
Subglandular silicone gel implants give most natural breast results. Nature designed woman's breast in front of the muscle and that is way it should remain after any plastic surgery (some excetions to this rule do exist).
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Subglandular for my Breast Anatomy? (photo)
I know you don't want a lift.....but...eventually you are going to need one. Right now your nipple and areola are the lowest parts of your breast and I think the only option for you at this point is above the muscle, or very very high dual plane, knowing that you will be droopy and most likely will need a lift in the near future...Implants will make you droop faster as well...
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Subglandular Breast Augmentation
Hello NewMePls,
Do not go with what your PS says! Subglandular breast augmentation with saline implants has no home. It is arcane, and will give you a poor result that will get worse with time - ball in a sack.
You have breast ptosis (sagging) and this would best be addressed at the time of breast augmentation. No technique of breast augmentation alone will make your breasts look as nice as they would with a breast lift too.
Please do yourself a real favor and meet...
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Wailt Before You Proceed
Ok. No company line statement. You have ptosis (droop). Placing subglandular implants into droopy breasts will give you larger droopy breasts. You will need a lift in addition to implants (subglandular or submuscular). Silicone implants if you are going to go subglandular are recommended.
A dual plan augmentation, silicone implants and a lift would give you the result that you most likely desire.
Dr. ES
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Implant pocket
I prefer placing most implants under the muscle for more soft tisse coverage. You may need a lift as well.
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Subglandular implants to lift nipple
Hi,
You are headed for a great deal of disappointment unless you are willing to accept the DOUBLE BUBBLE effect. This will happen with the implant under or over the muscle. Your case is an easy prediction.
You should plan on having the breast lift very soon after your implants unless you are prepared for the "unit" of the implant and breast tissue to be in two places.
I too prefer under the muscle with the implants but your situation is not about...
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Breast implants do not fix breast sag
Breast implants make your breast larger, not higher. And larger usually means heavier and lower.
If your breast looks like the images shown, making it larger will make it also lower and sag more.
A skillfully performed limited incision breast lift with an implant can lift the breast, increase fullness in the upper pole, and prevent sagging later.
Best wishes for a positive outcome!
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Saline over the muscle
Thanks for your inquiry. You requested an honest answer. If you were my patient I would not let you do a saline implant over the muscle. At the minimum I would tell you to have a dual plane augmentation, silicone preferrably to reduce wrippling, and tell you to do a peri-areolar lift. I understand the philosophy and plan of being less invasive like avoiding a lift and waiting a year or so to see if you are happy, but I am...
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Subglandular Implants
Saline implants in the subglandular position tend to cause visible rippling. To avoid rippling it is better to place the implants under the muscle with a dual plane technique. Your photos show a degree of breast ptosis and I would recommend a breast lft with your augmentation. The breast lift will reposition the breast mound over the implant. Large subglandular implants are not a substitute for a breast lift and patients often end up disappointed with their results.
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Implant positioning
The issue you are confronting is loss of breast volume made worse by the skin not tightening or retracting creating a lower nipple position. Placing an implant directly under the skin will make the skin tighter because you are filling the container not addressing the skin laxity. Implants don't lift the nipple position and the added weight will lead to further skin stretching. You will most likely require a lift within a year or two with this operation anyway.
The ideal operation...
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Submuscular Implants Are Generally Preferable
I almost always place implants below the chest muscle and feel that this provides better results. If you do decide to stay with the recommendation that your implants be placed subglandularly, I would stronfly recommend using silicone as the rippling rate for saline over the muscle is quite high.
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Above or below the muscle breast implants
I would recommend that you have submuscular (dual plane) implants and see if you are happy. You can always do a lift later since implnts above or below the muscle do no lifting. Saline above the muscle is a poor choice for me.
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Saline above the muscle? Bad idea?
I would recommend to you if you came into my clinic, silicone below the muscle utilizing the dual plane technique to allow the implant do fall into position and the breast to expand and that would provide the best coverage of the implant, IMO saline above the muscle at that size is a bad idea
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How to avoid having a breast lift performed.
In the aesthetic surgery Journal volume 33 (1) 43-65 is a very good article supporting using dual plane breast augmentation for a problem similar to yours. This involves a little bit more surgery on the inside of your breast but can give a better lift result than either submuscular or subglandular alone. Based upon your pictures and a physical examination, that approach might be valid for you. Historically, I would've recommended a lift. The dual plane technique avoids the...
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Saline and Over the Muscle
If you are trying to avoid a lift, there is an argument to be made in going over the muscle. However, if you have very little tissue in the superior pole, this is generally not recommended. In addition, a silicone implant can be used to reduce the rippling that is a somewhat worse with saline. However, be aware that rippling occurs with silicone, and muscle coverage helps to prevent rippling as well. Kenneth Hughes, MD Los Angeles, CA
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Subglandular Breast Augmentation
For the best result, a breast lift would be recommended. Since you do not want a breast lift, you may want to consider silicone gel implants. With the subglandular augmentation, you do not have the muscle covering the implant. Saline implants on top of the muscle sometimes show ripples. The result is much better with the gel implants.
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